ADHD (Attention Deficit Hyperactivity Disorder) is a hereditary neurobiological developmental disorder that occurs in childhood, where information in the brain is transmitted differently than in people without ADHD. People with ADHD are often restless, easily distracted, busy-headed and impulsive. Because research was previously only done on boys and men, ADHD in women is often overlooked, says Sandra Kooij. She is a psychiatrist and professor of ADHD in adults at Amsterdam UMC/VUmc and mental health institution PsyQ The Hague and is known worldwide for her research in adults.
“Women often don’t know that they have ADHD. It was always a disease for boys, which manifested itself in busy, aggressive and rebellious behavior. But girls and women show different behavior: anxious, depressed, doubtful, dependent on others. You see that they often underperform at school or at work and suffer multiple burnouts because they have to work harder to achieve the same due to their concentration problems.”
‘A clusterfuck, my patients sometimes say’
According to Kooij, hormonal mood problems, including depressive and suicidal thoughts, occur two to three times more often in women with ADHD than in women in general. They often suffer from this in the week before their period, as well as after pregnancy or during menopause. “During these periods, estrogen in the body drops. This substance ensures focus and a stable mood in the brain. Estrogen does the same thing as dopamine, but people with ADHD probably already have low levels of dopamine, so these women suffer extra from it. A clusterfuck, my patients sometimes say.”
A Swedish population study shows that adults (men and women) with ADHD have a 38 percent increased risk of cardiovascular disease, compared to 23 percent in the general population. According to Kooij, this is because people with ADHD often have a less healthy lifestyle. They more often suffer from sleep deprivation and are more likely to be obese, factors that are more likely to lead to cardiovascular disease.
“And in our own research (together with Janneke Wittekoek of Heartlife Klinieken), screening of three hundred (peri)menopausal women with heart complaints showed that 35 percent have lifelong ADHD symptoms. That is ten times more common than in the general population. So there is clearly something going on with ADHD and the heart.” According to Kooij, women often only discover that they have ADHD during menopause. During this period, estrogen levels slowly decrease. Estrogen protects the heart, so all women are more likely to develop heart problems. In combination with the other lifestyle factors, the risk appears to be increased in women with ADHD.
Stress is bad for everything
As a woman with ADHD, can you do something to prevent cardiovascular disease? “Yes, take your complaints seriously and don’t wait until you get stuck at work or end up at the cardiologist,” says Kooij. “Have your ADHD, sleep and mood complaints diagnosed and treated; this significantly reduces your stress level. Stress is bad for everything and puts a strain on your head, heart and immune system.”
She recommends then starting a serious lifestyle change – eating healthier, exercising more and sleeping well – and having your blood pressure, glucose, cholesterol and BMI measured by your GP from the age of 45. Women with ADHD are also more likely to enter menopause early – before the age of forty. In case of menopausal symptoms, Kooij advises to consider hormone therapy in a timely manner, in consultation with your GP, to protect sleep, mood, heart and bones. Because ADHD, menopause and heart disease are related, Kooij co-founded the Head Heart Hormones (H3) network this year, which aims to promote integrated care for women with these complaints.
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The Consult
2023-11-02 19:52:59
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